Main branch of ACN-to-RLN for management of laryngospasm due to unilateral vocal cord paralysis
Main branch of ACN-to-RLN for management of laryngospasm due to unilateral vocal cord paralysis
复制标题
ACN-to-RLN 的主要分支，用于治疗单侧声带麻痹引起的喉痉挛
DOI：
10.1002/lary.28426
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发表时间：
2019
期刊：
影响因子：
2.6
通讯作者：
Zheng H.
中科院分区：
文献类型：
--
作者：
Wang W;Sun J;Tang H;Gao Y;Chen S;Li M;Zheng H.
目的/假设本研究探讨颈袢神经 (ACN) 主支与喉返神经 (RLN) 吻合术治疗单侧声带麻痹 (UVCP) 引起的阵发性喉痉挛的可行性和有效性。 方法 13 名接受颈袢神经主支与喉返神经 (RLN) 吻合术的患者 本研究纳入了用于治疗 UVCP 引起的阵发性喉痉挛的吻合术。术前和术后进行多维评估，包括视频频闪镜检查、声音评估和喉肌电图（LEMG）。结果本系列仅限于医源性原因的UVCP，包括甲状腺切除术、颈椎手术和胸外科手术。 ACN-RLN 主分支吻合后，所有病例均显示气道明显改善，92.3% 的病例（13 例中的 12 例）喉痉挛完全消除。视频频闪镜检查显示，嗅觉时受影响声带的膨出和反常内收现象在术后立即消失，并且术前与术后声带位置或声门闭合没有显着差异。 LEMG 显示，与术前相比，术后受影响的甲杓肌在嗅觉过程中的自愿运动单位电位的募集和幅度显着下降，并且与术前相比，术后在发声期间的募集显示出显着改善。声音评估显示，术后总体等级、粗糙度、呼吸音、抖动（局部）、闪烁（局部）、噪声谐波比或最大发声时间与术前相比均无显着差异。结论 ACN-to-RLN 吻合术主干对治疗 UVCP 所致阵发性喉痉挛具有长期疗效，且无明显差异。 语音质量的妥协。证据水平4喉镜，130：2412–2419，2020
Objectives/HypothesisThis study explored the feasibility and efficiency of main branch of ansa cervicalis nerve (ACN)‐to‐recurrent laryngeal nerve (RLN) anastomosis for management of paroxysmal laryngospasm due to unilateral vocal cord paralysis (UVCP).MethodsThirteen patients who underwent main branch of ACN‐to‐RLN anastomosis for management of paroxysmal laryngospasm due to UVCP were enrolled in the present study. Multidimensional assessments, including videostroboscopy, voice assessment, and laryngeal electromyography (LEMG), were performed preoperatively and postoperatively.ResultsThis series was limited to UVCP with iatrogenic causes, including thyroidectomy, cervical spine surgery, and thoracic surgery. After main branch of ACN‐to‐RLN anastomosis, all cases showed significant airway improvement, and laryngospasm was completely abolished in 92.3% (12 of 13) of cases. Videostroboscopy showed that the bulging and paradoxical adduction of the affected vocal cord during a sniff were abolished immediately after operation, and there was no significant difference in vocal fold position or glottal closure before versus after the operation. LEMG showed that the postoperative recruitment and amplitude of voluntary motor unit potential in the affected thyroarytenoid muscle during a sniff were significantly decreased compared to preoperative values, and postoperative recruitment showed significant improvement during phonation compared to that preoperatively. Voice assessment showed that there were no significant differences in overall grade, roughness, breathiness, jitter (local), shimmer (local), noise‐to‐harmonics ratio, or maximum phonation time after the operation compared to the preoperative values.ConclusionsMain branch of ACN‐to‐RLN anastomosis could have long‐lasting efficacy in the management of paroxysmal laryngospasm due to UVCP, with no apparent compromise of voice quality.Level of Evidence4Laryngoscope, 130:2412–2419, 2020